| NPI | 1376700351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TY BARRUS Director 307-271-7460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2008-05-19 |